Renal transplant from infant and neonatal donors is a feasible option for the treatment of end-stage renal disease but is associated with increased early graft loss
Autor: | Richard Baker, Matthew Welberry Smith, Sonsoles Martinez-Lopez, C. Ecuyer, Imeshi Wijetunga, Chirag Patel, Niaz Ahmad, Muhammad Jameel, Michael Weston |
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Rok vydání: | 2018 |
Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Brain Death Tissue and Organ Procurement Adolescent 030232 urology & nephrology Renal function Delayed Graft Function 030230 surgery Graft loss End stage renal disease Donor Selection 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Risk Factors medicine Immunology and Allergy Humans Pharmacology (medical) Prospective Studies Child Kidney transplantation Transplantation Kidney business.industry Graft Survival Infant Newborn Infant Middle Aged medicine.disease Prognosis Kidney Transplantation Tissue Donors Surgery medicine.anatomical_structure Increased risk Renal transplant Child Preschool Kidney Failure Chronic Female business Follow-Up Studies |
Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 18(11) |
ISSN: | 1600-6143 |
Popis: | Kidney transplants from young pediatric donors are uncommonly performed in the UK. Published literature of kidney transplant from donors weighing less than 5 kg is sparse. We present our initial experience of en bloc kidney transplantation (EKT) from donors weighing less than 20 kg, including neonatal donors. All recipients undergoing EKT from donors under 20 kg at our center from January 2005 to October 2016 were included. Donor and recipient details were recorded from a prospective database. Electronic patient records were examined for follow-up data. Of 30 EKTs included, 15 were from ≤5 kg donors and 15 from >5 kg donors (median weight 3.4 and 12.7 kg, respectively). One-year graft survival for ≤5 kg and >5 kg donors for EKT was 86.7% and 93.3% (P = 0.85), respectively. Progressive improvement in estimated GFR (eGFR) was noted in both donor categories through first-year posttransplant but in the ≤5 kg donor category significant improvement was seen at 12 months compared to 3 months after transplantation (median eGFR 37.3 vs 70.0 mL/min/1.73 m2 , P = 0.03). Two early graft losses were attributable to early vascular complications and one graft loss due to primary nonfunction. Our data show that kidney transplantation from such donors is a feasible option at centers with experience of EKT, albeit with increased risk of early graft loss. |
Databáze: | OpenAIRE |
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